An elderly patient who was implanted with an SJM Identity® XL DR model 5376 pacemaker for sick sinus syndrome was seen in follow-up on March 7, 2007. She had been complaining of periodic rapid palpitations associated with marked weakness and pre-syncope, but she never fainted. Her primary care physician obtained a Holter monitor showing isolated PVCs, isolated APBs and atrial pacing with intact AV nodal conduction. She was asymptomatic during the Holter study. The stored EGMs available in the pacemaker demonstrated a number of AV nodal reentrant tachycardia (AVNRT), initiated by a non-sustained run of ventricular tachycardia. One of these episodes is shown in this case study but all were similar.
